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Old 08-17-2009, 12:43 PM   #1
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OATS for 1.5mm Lesion or Larger?

I just got back from my doctor and he told me that many doctors would probably go straight to fusion and skip OATS with the size of lesion I have. He guesses I have only a 50% chance that the OATS would work. The only other step would be ankle fusion. Given my age, I'm not too keen on that idea (or possible future knee arthritis). But I'm also not too keen on going through the hell of the OATS surgery for nothing.

I have given permission for them to go ahead and find me a cadaver talus. I was wondering if any of you have had comparable lesions and what you chose to do about it, especially if you chose OATS, and if it was successful or not.

T

 
Old 08-17-2009, 04:26 PM   #2
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Re: OATS for 1.5mm Lesion or Larger?

I assume you mean a 1.5 cm lesion as a 1.5 mm lesion is tiny. I had a 1.3 cm lesion and the OD gave a 70% chance of success for an OATS allograph. I decided to go for it and I had two 10 mm nested grafts in early May. I decided to go this route instead of fusion because:

1-The OD I was seeing was one of the original developers of OATS and he has done many, many procedures so it made me really trusted his odds.

2-The chance of a normal ankle was worth the pain/hassle of an OATS surgery even at 39 years old.

I'm now at 3 months post-op, walking and doing PT. Still having pain and from x-rays it isn't clear if the grafts have properly joined to my talus....so I wouldn't know if it is a success for another couple of months at least. But I would make the same choice if I did it all over again.

 
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Old 08-17-2009, 05:19 PM   #3
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Re: OATS for 1.5mm Lesion or Larger?

Do a search for OATS here. YOu will find a wealth of info.
I had a 1cm OATS procedure done last Sept. It is fully healed and was a success. I'm 40, almost 41 and very active with karate and running.
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Brostrom x2, peroneal tendon repair x2, Peroneal subluxation, PTT tendon repair, microfracture x5, OATS, Distraction arthroplasty, ORIF talus & fibula, subtalar fusion, ankle replacement (failed)
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Old 08-17-2009, 06:59 PM   #4
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Re: OATS for 1.5mm Lesion or Larger?

Indyjones, indeed, 1.5cm. I knew I shouldn't of tried to convert that number, lol. I don't believe I can have the same comfort with my doctor as you have but I do feel it's worth a go, considering I'll be 33 tomorrow. When the doctor told me the odds of OATS working for me, my heart sank.

I have done a lot of OATS reading here and have learned a lot. I've a lot more threads to go, lol. Congratulations on the successful OATS!

Last edited by Administrator; 04-12-2011 at 10:19 AM.

 
Old 08-18-2009, 12:20 PM   #5
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Re: OATS for 1.5mm Lesion or Larger?

Jenafur,

I had 2 plugs - one 10mm and one 8mm (1.8 cm) put in my talus and I am now hiking mountains a year and a half after surgery. I definitely think it's worth trying OATS. I'm still amazed the pain in my foot is gone and I can do most of my previous activites. It took about 9 months minimum to get back towards normal but it was worth it for sure! My OS said my OCD was HUGE but I have had success!

Abby

 
Old 08-18-2009, 01:14 PM   #6
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Re: OATS for 1.5mm Lesion or Larger?

Hey Abby,

Were your two plugs for the same OCD or did you have 2 spots? Just curious.
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Brostrom x2, peroneal tendon repair x2, Peroneal subluxation, PTT tendon repair, microfracture x5, OATS, Distraction arthroplasty, ORIF talus & fibula, subtalar fusion, ankle replacement (failed)
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Old 08-18-2009, 01:19 PM   #7
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Re: OATS for 1.5mm Lesion or Larger?

Abby, that's very encouraging and definitely makes me feel better about my decision.

 
Old 08-18-2009, 02:45 PM   #8
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Re: OATS for 1.5mm Lesion or Larger?

Hi Jennafur,
I had the OATs procedure in March of this year and am doing great!
Initially my doctor planned to take two plugs from my knee because the MRI showed I had a 2cm lesion. It turns out my lesion was 9mm instead, so almost a centimeter. He took one plug from my knee.
I am happy with my decision to go through with the surgery. The ankle pain I had prior to surgery is gone. I'm still in physical therapy and this has not been a fun recovery process, but as Abby says, well worth it Try to find a surgeon who has done more of these procedures...maybe he or she can give you better success rates. My doctor gave me a 92% success rate...that's pretty good!
Best Wishes

Oh, and I'm 30 years old...
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Last edited by anklehelp; 08-18-2009 at 02:45 PM.

 
Old 08-18-2009, 08:20 PM   #9
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Re: OATS for 1.5mm Lesion or Larger?

Thank you, Anklehelp. Maybe there's a chance he'll go in and see that my lesion isn't quite that bit but I don't have high hopes as he's already dug around in there while doing the debridement. Smaller the better though... gots my fingahs crossed!

 
Old 08-19-2009, 09:53 AM   #10
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Re: OATS for 1.5mm Lesion or Larger?

Kris,

I had one OCD but it was pretty weird looking. I had one distinct 'hole' in my foot but then around it many 'geodes' as it was called on my CT report. The geodes were like little porous areas almost like looking at a sponge where my bone was disintegrating. My OCD never actually got to the point of disintegrating with loose bodies floating around but the bone itself looked like swiss cheese. I was given an 85% success rate at the age of 39!

 
Old 08-19-2009, 08:32 PM   #11
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Re: OATS for 1.5mm Lesion or Larger?

Kris, my doctor said that he would use two plugs for my one spot, due to the size.

Akirka, your lesion was larger and you're a touch older than me and you were given 35% better odds than I did. Hopefully my odds are indeed better than 50%.

 
Old 08-20-2009, 04:19 AM   #12
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Re: OATS for 1.5mm Lesion or Larger?

Jennafur,
I had 2 plugs also, but the way Abby said hers was and the size of each plug, it sounded like it could be 2. Mosaicplasty is the term used for more than one plug and so technically that's what many of us had, even though it's the same thing, pretty much as OATS.
I wasn't given a % odds, but I had mine done at 39 (almost 40) and it worked. That spot has no more pain. My spot was only 1cm.
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Brostrom x2, peroneal tendon repair x2, Peroneal subluxation, PTT tendon repair, microfracture x5, OATS, Distraction arthroplasty, ORIF talus & fibula, subtalar fusion, ankle replacement (failed)
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Old 08-20-2009, 09:00 AM   #13
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Re: OATS for 1.5mm Lesion or Larger?

jennafur,

i also had 2 plugs from my knee. i think my lesion in my talus was 1.3 cm. I just turned 28 and was given a 90% succes rate. its hard to judge this surgery from a percentage...everybody's different and obviously age, weight, and health all play a factor in this. I am 4 + months out and i feel really good. This surgery isnt easy and it was and is going to be a loooong recovery process but completely worth it. i feel like i have a 'new ankle' now and i am very happy with my decision to do this surgery. wish i would have done it a year and half ago instead of the microfracture/drilling surgery (which failed and just made it worse and the lesion bigger over time) My advice is to get more opinions from other docs and to see someone who specializes in this surgery and has a lot of experience with it.

 
Old 08-20-2009, 12:41 PM   #14
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Re: OATS for 1.5mm Lesion or Larger?

Jennafur,

I also had 2 plugs taken from my knee and put into a 7 x 9 by 6 deep OCD.

I am with Bumankle ... I am glad I did it and wished I did it instead of the failed drilling first. I am just a year out now and not really where I'd like to be at this point, but have to admit the stabbing pains that I had before the OATS are gone .. just now dealing with other non OCD issues I think. (I was in the boot for almost 2 years so I think tendons etc. atrophied in my case)

Get as many opinions as you can and do a lot of reading so you know what questions to ask. (Also make sure on the insurance coverage before you begin .. I'm sure you read that many of us had some 'issues.')

Good luck!
Kim

 
Old 09-15-2009, 02:02 AM   #15
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Re: OATS for 1.5mm Lesion or Larger?

I haven't posted here in quite some time. I had a failed microfracture for a 1.5 cm lession in July 2007. I know that I need the allograph from cadaver tissue. My problem is this. I have no health insurance now. Even when I get health insurance, my only options in Pittsburgh will be the same dr. who did the drilling and he doesnt do the surgery I need

How can I possibly find a dr. who is experienced with the surgery that i need? Anyone have any ideas? I keep on walking around on this thing and am quite sure it has got to be about 2 cm by this point.

Thanks for you help guys

 
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